Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Mirtazapine(click to collapse)
1/4 selected
Mirtazapine
Remeron · Mirataz
Noradrenergic and Specific Serotonergic Antidepressant
FDA-approved indications
- Major depressive disorder (adults)
Off-label uses
- Insomnia
- Appetite stimulation/weight gain
- Nausea (chemotherapy or other)
Half-life20 to 40 hours
Decision GuideWhen to pick each / when to consider an alternative
Mirtazapine
Consider when
- Insomnia-predominant depression — improves total sleep time, slow-wave sleep (N3), and efficiency without REM suppression
- Underweight, cachectic, or anorectic patient — weight gain (+0.87 kg/8 wk) and appetite stimulation (17% vs 2%) are therapeutic goals
- Sexual dysfunction on SSRIs/SNRIs — ~24% SD vs 58–73% with SSRIs; no serotonin reuptake inhibition mechanism
- Comorbid nausea or GI distress — 5-HT3 antagonism (antiemetic mechanism) causes significantly less nausea than SSRIs/SNRIs
- +1 more
Consider an alternative when
- Daytime sedation cannot be tolerated — somnolence 54% vs 18% placebo; leading discontinuation cause at 10.4%
- Weight gain is unacceptable — Pillinger 2025 +0.87 kg; FDA label weight gain 12% vs 2%, appetite increase 17% vs 2%
- Metabolic syndrome, diabetes, or obesity — sustained appetite/weight signal; bupropion or vortioxetine preferred metabolically
- Prior DRESS, SJS, TEN, or bullous reaction — contraindicated for re-exposure per FDA label
- +1 more
| Axis | Mirtazapine NaSSA |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Agranulocytosis / severe neutropenia | |
DRESS / multiorgan hypersensitivity | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Emotional blunting | |
Seizure risk | |
| Metabolic | |
Weight gain | |
| Autonomic | |
Anticholinergic burden | |
Angle-closure glaucoma | |
| Cardiac | |
QTc prolongation | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
CYP interactions / DDI profile | |
| Pregnancy | |
Lactation / breastfeeding safety | |